Juvenile vertebral osteochondrosis
Introduction
Introduction to juvenile vertebral osteochondrosis Juvenile vertebral osteochondrosis, also known as Scheuermann's disease, or young hunchback. The age of onset is 13 to 17 years old, males are slightly more than females, 75% of cases occur in the thoracic vertebrae, especially the lower thoracic vertebrae, 25% can involve the thoracic vertebrae and upper lumbar vertebrae, especially the lower thoracic vertebrae, and 25% can involve the thoracic vertebrae and the upper lumbar vertebrae. The incidence rate is unknown. According to statistics, it accounts for 6% of the military and 8% of industrial workers. There is a congenital or developmental defect in the joint between the spongy bone and the cartilage. When the weight is excessive, the nucleus pulposus of the intervertebral disc protrudes into the vertebral body, destroying the vertebral cartilage plate and causing the growth imbalance; at the same time, the intervertebral disc also loses the buffer (protection). The action causes excessive pressure on the anterior edge of the vertebral body, causing growth retardation, vertebral wedge deformation and fragmentation. basic knowledge The proportion of illness: 0.0005% Susceptible people: children Mode of infection: non-infectious Complications: vertebral tuberculosis
Cause
The cause of juvenile vertebral osteochondrosis
Regarding the etiology of this disease, some scholars believe that this disease is aseptic necrosis of the annular epiphysis. The vertebral body has three ossification centers, namely the primary ossification center in the middle of the vertebral body and the secondary ossification of the upper and lower ends of the vertebral body. Center, the latter known as the annular epiphysis, appears after the age of 4, located at the edge of the cartilage plate, separating the vertebral body from the intervertebral disc, but this statement has been denied, the main lesion in the intervertebral cartilage, because in the spongy bone There is a congenital or developmental defect in the junction with the cartilage. When the weight is excessive, the nucleus pulposus of the intervertebral disc protrudes into the vertebral body, destroying the vertebral cartilage plate and causing the growth imbalance. At the same time, the intervertebral disc also loses the buffer (protection) effect. The anterior edge of the vertebral body is subjected to excessive pressure, causing growth retardation, wedge deformation and fragmentation of the vertebral body, and the posterior edge of the vertebral body maintains the original height due to the protection of the posterior articular process, and the spine produces a posterior deformity.
Prevention
Juvenile vertebral osteochondrosis prevention
It is believed that this disease is due to congenital dysplasia is one of the causes of this disease, so there is no effective preventive measures, but it should be noted that although this disease is a self-healing disease, the activity period is about 2 years. However, if there is a hunchback deformity, it is impossible to completely correct it. In the early stage of adulthood, osteoarthritis will be secondary. Therefore, once the disease is diagnosed, it must be actively treated.
Complication
Juvenile vertebral osteochondrosis complications Complications
Juvenile vertebral osteochondrosis often occurs in adolescents with rapid growth. The main cause of most patients is kyphosis, some of whom may have back pain, and 50% complain that the pain is mainly in the deformed or lower back. After the activity is aggravated, it usually decreases with the end of growth. Only 25% of the patients after the maturity period have more typical symptoms. If the pain is located at the waist and the deformity is in the chest, the possibility of pedicle cracking should be considered.
Symptom
Symptoms of juvenile vertebral osteochondrosis common symptoms scapula protruding hunchback chest narrow and flat
Humpback is the main symptom, with spinal rigidity, neck flexion, shoulder drooping, chest narrow and flat, scapula protruding, pain is not serious, often pain, hunchback deformity develops to 20 years old.
Examine
Examination of juvenile vertebral osteochondrosis
The auxiliary examination of this disease is mainly X-ray examination, which is as follows:
1 On the vertebral body, there are irregular indentations on the lower front edge, and the shape and size of the corresponding part of the annular epiphysis are not uniform and are separated from the vertebral body.
More than 2 vertebral bodies were wedge-shaped in front of the vertebral body with Schmorl nodules.
3 slight stenosis of the intervertebral space.
4 thoracic or thoracolumbar kyphosis is more than normal 25 ° ~ 40 °.
5 years later, osteoarthritic spurs appeared early in the anterior vertebral body.
Diagnosis
Diagnosis and differentiation of juvenile vertebral osteochondrosis
Diagnose based on
1 teenager.
2 Humpback malformations must exceed 35°.
3 At least one of the vertebral body leading edges has a wedge deformation greater than 5°.
4 need to continuously affect 3 to 5 vertebral bodies.
Differential diagnosis
The disease should be distinguished from the following diseases.
1. Spinal tuberculosis: For progressive bone destructive disease, the edge of the vertebral body is blurred and not as white as osteochondrosis, and paravertebral abscess occurs in most patients.
2, posture hunchback: This kind of hunchback is not fixed, it is easy to passively or automatically correct, there is no wedge deformation of the vertebral body on the X line.
